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Biomedical subjects

M Averbuch

Publications and source records attributed to M Averbuch.

At least 37 records · Page 2Linked to original sources
PubMed1992

The differential leukocyte count in adults with acute gastroenteritis.

The total and differential leukocyte count of 4 groups of patients, admitted to the hospital because of acute gastroenteritis was evaluated. The 4 groups included: (a) 131 adult patients with positive stool culture for shigella; (b) 23 children (age less than 15 years) with positive stool culture for shigella; (c) 52 adult patients with positive stool culture for salmonella; (d) 43 adult patients with negative stool culture for bacterial pathogens. The total leukocyte count did not contribute to the differential diagnosis between shigella gastroenteritis and gastroenteritis of other etiology. However, the absolute band count was significantly higher in adults with shigella gastroenteritis. Moreover, a band to total neutrophil ratio further increased the diagnosis specificity. The differential leukocyte count can contribute to early diagnosis of shigellosis in adult patients.

Acute Disease↗
PubMed1991

[Sedural toxicity].

Phenazopyridine (Sedural) is widely used in the treatment of dysuria. It is considered a benign drug and most physicians are unaware of its potential toxicity. A 24-year-old woman who developed methemoglobinemia, acute renal failure and hemolytic anemia following a single 1 g dose of the drug is presented.

Acute Kidney Injury↗
PubMed1991

The effects of hormone replacement therapy in normal postmenopausal women: measurements of Doppler-derived parameters of aortic flow.

In this study the effects of hormone replacement therapy on cardiac function in healthy postmenopausal women were evaluated by Doppler echocardiography that was performed before (T1) and 2.5 months after the initiation of hormone replacement therapy (T2) in the peak estrogenic phase. The following parameters of aortic flow were measured: peak flow velocity, acceleration time, and ejection time. Additional parameters were calculated: flow velocity integral and mean acceleration. The study group included 24 postmenopausal women aged 43 to 60 years (mean 51.6 years). The control group consisted of 19 postmenopausal women aged 46 to 60 years (mean 53.5 years) who were not receiving hormone replacement therapy and who underwent the same evaluation. There were no changes in all Doppler parameters between T1 and T2 in the control group. However, in the study group there were significant increases in peak flow velocity (108.3 +/- 16.7 cm/sec at T1 vs 123 +/- 20.7 cm/sec at T2; p = 0.002), flow velocity integral (17.7 +/- 3.9 vs 21.5 +/- 4.7 cm; p = 0.0003), mean acceleration (11.5 +/- 1.9 vs 13.1 +/- 2.6 m/sec/sec; p = 0.001), and ejection time (324 +/- 37.6 vs 348.8 +/- 40.7 msec; p = 0.002). There was no change in acceleration time (94.8 +/- 6.6 vs 95 +/- 10.9 msec). These results demonstrate that estrogens increase both stroke volume and flow acceleration. The latter probably reflects a combination of enhanced inotropism and vasodilatation. We assume that the cardioprotective effect of hormone replacement therapy in postmenopausal women may be due not only to changes in lipid profile but also to direct effects of estrogens on central and peripheral hemodynamic parameters.

Adult↗
PubMed1991

Budd-Chiari syndrome in Israel: predisposing factors, prognosis, and early identification of high-risk patients.

In twenty-seven patients with venography-documented Budd-Chiari syndrome (BCS), underlying diseases included polycythemia vera (nine patients), membranous occlusion of the inferior vena cava (three), and cirrhosis (two). In only nine patients did the syndrome occur in the absence of any predisposing factor. All patients with a membranous web were relatively young (mean age 29 years) and were born in Morocco. With regard to prognosis, three groups could be delineated. Eight patients formed a rapidly progressive group, with mean survival from first symptom of only 4.3 weeks, and were characterized mainly by their relatively advanced age and minimal enlargement of the spleen.

Adult↗
PubMed1991

Aortic dissection manifested as fever of unknown origin.

Aortic dissection is accompanied by fever in about one third of the patients. However, fever of unknown origin as the predominant manifestation of aortic dissection seems to be extremely rare. A review of the English literature revealed only 3 patients characterized by fever as the principal sign of aortic dissection. Herein an additional patient is reported. All 4 patients presented with pain or discomfort in the chest, back or abdomen, followed by persistent fever, lasting 5-11 weeks and associated with anemia and a high sedimentation rate. The outcome was favorable in all cases regardless of the location of the dissection or the type of treatment.

Aged↗
PubMed1991

Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure.

We evaluated the safety of enalapril administration in 20 very old (76 +/- 7 years) patients with rapidly progressive congestive heart failure (deteriorating from New York Heart Association class 2 to class 4 on admission). They were all given increasing doses of enalapril regardless of concomitant diuretic therapy and state of hydration. Renal function deteriorated in four patients (group A) and remained unchanged in 16 (group B). The mean pretreatment serum creatinine level in group A was significantly higher than that in group B (2.4 vs 1.3 mg/dl, p less than 0.001). No patient with a serum creatinine level less than 1.9 mg/dl on admission had further impairment of renal function. Groups A and B did not differ by age, concomitant diseases (including hypertension and diabetes mellitus), or medications (including diuretics) or by in-hospital serum electrolyte concentrations and blood pressure. Renal damage was noted during the initial four days of the study and was reversible following discontinuation of enalapril. Our data suggest that enalapril can be safely administered to very old patients with rapidly progressive congestive heart failure provided that the initial serum creatinine level is below 1.9 mg/dl. In patients with a higher serum creatinine level, careful monitoring and prompt discontinuation of enalapril administration can prevent irreversible renal damage.

Age Factors↗
PubMed1989

Gentamicin blood levels: ordered too soon and too often.

Records of 100 consecutive patients in whom gentamicin blood levels (GBLs) had been measured were reviewed to assess the relation between GBL, disease course, and outcome. Thirty-two patients discontinued treatment, 16 within 72 hours because of negative cultures or improved clinical course, and 16 within 96 hours because susceptibility tests indicated that another antibiotic would be more appropriate. Of the remaining 68 patients who continued treatment, 21 recovered from their infection despite low peak or low peak and trough gentamicin levels, at least partially attributable to treatment with multiple antibiotics. Renal function deteriorated in only 1 of 10 patients with normal renal function and a high GBL. Our findings of early discontinuation of gentamicin, low concentrations with good outcome, and rare nephrotoxicity indicate wasteful overuse of GBLs. To decrease patient care costs without adversely affecting outcome, gentamicin measurements should be delayed for 72 to 96 hours--until culture results become available--except in patients with decreased renal function, documented gram-negative sepsis, leukopenia, or severe burns.

Adult↗
PubMed1989

Protein intake and kidney function in humans: its effect on 'normal aging'.

The effect of dietary protein on kidney function expressed by creatinine clearance was studied in healthy subjects following a "normal" unrestricted protein diet and compared with a group of vegetarians maintained on a long-term low-protein diet. Both groups had similar kidney function and displayed the same rate of progressive deterioration in renal function with age. These results suggest that, in contrast with the important therapeutic effect of low-protein intake on the progressive deterioration of kidney function in diseased kidneys, such a diet does not significantly affect kidney function with "normal aging" in healthy subjects.

Adult↗
PubMed1988

Red blood cell sorbitol lowering effects and tolerance of single doses of AL 1576 (HOE 843) in diabetic patients.

The safety and biochemical effects of AL 1576 (HOE 483), a recently developed aldose reductase inhibitor, were evaluated. In a double-blind, placebo-controlled, clinical trial, AL 1576 (HOE 483) was administered to diabetic patients for the first time. Four single, orally administered dose levels were tested, (2, 5, 10, and 20 mg). No clinically important adverse effects were seen in any of the patients. AL 1576 (HOE 483) suppressed red blood cell (RBC) sorbitol concentrations in a dose-related fashion. Also found were statistically significant inverse correlations between the plasma drug concentration and both RBC sorbitol concentrations as well as RBC sorbitol/serum glucose ratios. In single doses up to 20 mg, AL 1576 (HOE 483) is well tolerated and decreases RBC sorbitol, a biochemical marker of pharmacologic activity, in diabetic patients.

Adolescent↗
PubMed1988

Severe congestive lupus cardiomyopathy complicated by an intracavitary thrombus: a clinical and echocardiographic followup.

Severe congestive cardiomyopathy is an uncommon complication of systemic lupus erythematosus (SLE). We describe a patient with active SLE and a circulating anticoagulant. She presented with a rapidly progressive cardiomyopathy, complicated by an intracavitary thrombus and cerebral infarction. The course of the disease is described, with special emphasis on the usefulness of consecutive echocardiographic studies.

Adolescent↗
PubMed1987

Computer-aided information system to support direct patient care. The application of a hand-held data collector in a department of medicine.

In the pilot study, described herein, we have tried to develop a computerized system to assist and improve medical and nursing care. Our major goal was to bring the computer to the patient's bedside. This was achieved by a Hand-Held Data Collector, which is easy to carry and operate, and has a big enough memory. In this preliminary study, we have developed appropriate software specifically designed to reflect the daily activities and needs of a department of medicine. Using this software, we have demonstrated that all 'clinical events' and routine tasks of the department can be managed via the Hand-Held Data Collector.

Computer Systems↗
PubMed1987

Lupus anticoagulant, thrombosis and thrombocytopenia in systemic lupus erythematosus.

Thirty-six patients were studied for the presence of the lupus anticoagulant and its possible clinical and laboratory associations. Seven patients were found to have the anticoagulant. These patients had a significantly increased incidence of both thromboembolic complications (5/7 vs. 2/29) and thrombocytopenia (4/7 vs. 4/29). None of them had a bleeding tendency. Except for these associations, patients with the anticoagulant did not differ from those without the anticoagulant by any demographic, clinical, or laboratory parameter. The present study confirms observations that SLE patients with the lupus anticoagulant have an increased risk of thrombosis.

Adolescent↗
PubMed1986

Budd-Chiari syndrome as the major thrombotic complication of systemic lupus erythematosus with the lupus anticoagulant.

A patient with systemic lupus erythematosus was first diagnosed after she had developed the Budd-Chiari syndrome. We believe that the Budd-Chiari syndrome was part of her tendency for thrombosis, induced by the presence of a lupus anticoagulant. The association between enhanced thrombosis and the lupus anticoagulant is discussed, and the need for prompt recognition and administration of anticoagulant therapy is emphasised.

Adult↗
PubMed1986

Longstanding intractable ascites as the initial and predominant manifestation of systemic lupus erythematosus.

Peritoneal involvement is quite common in systemic lupus erythematosus (SLE). However, significant ascites as the predominant manisfestations of SLE is extremely rare, and very few cases have been reported. We describe a patient with SLE whose disease first manifested as longstanding, painless and intractable ascites. The ascites preceded the diagnosis of SLE by 3 years. The diagnosis of SLE should be considered in patients with the so called "idiopathic" ascites. Once diagnosed, the ascites seem to respond promptly to corticosteroids, however, prior to their administration other potential causes, especially infections and malignancy, should be ruled out.

Adult↗